Individual provider Active NPI

Priscilla Marie Khademi Kalantari, LMFT

  • Marriage & Family Therapist
  • Bryan, TX
National Provider Identifier
1609028026
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
204185 Issued in TX
Practice address
3201 University Dr E Ste 325-1
Bryan, TX 77802-3475
Phone
(949) 686-5609
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 204185 TX Primary
Marriage & Family Therapist 106H00000X LMFT147393 CA

Addresses

Primary practice location

3201 University Dr E Ste 325-1
Bryan, TX 77802-3475

Mailing address

PO Box 9584
College Station, TX 77842-9584
Phone (949) 449-5933

Other practice location 1

3246 Arundala Way
Bryan, TX 77808-1490
Phone (949) 686-5609

Other practice location 2

3201 University Dr E Ste 325-1
Bryan, TX 77802-3475
Phone (979) 307-0479

Other practice location 3

3246 Arundala Way
Bryan, TX 77808-1490
Phone (979) 307-0479

Other names 1

  • Priscilla Marie Palacio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222000073 TX Practitioner - Marriage and Family Therapist 9234573866 Practice locations: Bryan, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT147393CAMDMarriage & Family Therapist
204185TXMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1609028026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9584",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778429584",
            "telephone_number": "949-449-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 325-1",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023475",
            "telephone_number": "949-686-5609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3246 Arundala Way",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778081490",
            "country_code": "US",
            "telephone_number": "949-686-5609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3201 University Dr E Ste 325-1",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778023475",
            "country_code": "US",
            "telephone_number": "979-307-0479",
            "fax_number": "979-205-5312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3246 Arundala Way",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "778081490",
            "country_code": "US",
            "telephone_number": "979-307-0479",
            "fax_number": "979-205-5312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHADEMI KALANTARI",
        "first_name": "PRISCILLA",
        "middle_name": "MARIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204185",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT147393",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRISCILLA",
            "last_name": "PALACIO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.